The Lessons of Iraq and Obamacare

Benjamin Domench is is a senior fellow at The Heartland Institute and publisher of The Federalist.

Domenech joined Heartland in 2009 after several years working and writing on national health care policy, beginning with a political appointment as speechwriter to U.S. Health and Human Services Secretary Tommy Thompson, and continuing as chief speechwriter for U.S. Senator John Cornyn during the Medicare Part D debate on Capitol Hill.

In addition to his work with Heartland and The Federalist, Domenech is the publisher of a daily subscription newsletter, The Transom, which is read daily by thousands of political insiders.

Domenech co-founded Redstate andhosts a popular podcast on market issues in the global economy -- and for which he won a "Sammy" award in 2011 — called Coffee & Markets.

In 2009 he was selected as a Journalism Fellow by the Peter Jennings Project for Journalists and the Constitution.

My own view is that whatever Bush’s personal qualities as a genuine, honorable fellow, his presidential legacy is of a lighter tax burden, a safer country… and a destroyed Republican Party. The last is not all his fault, but has more to do with who he picked for which jobs, and misplaced loyalty for those who served him ill. I view the entire second term of the Bush administration as a giant black hole for domestic policy: arguably, the only good thing the right got out of those four years was one reliable Supreme Court Justice, Samuel Alito, and they got that only after fighting tooth and nail against Bush’s instincts to choose Harriet Miers instead. And as for politics: Bush’s decisions, or the implementation thereof, destroyed the Republican brand as the adults in the room. The GOP cannot be the party of good governance, balanced foreign policy, and fiscal responsibility in the wake of Katrina, Iraq, the Bush deficits and the financial crisis – and the Republican Party’s inability to recognize the degree to which these factors undermined their core case for existing remains a tangible problem.

“Wehner, who by all accounts is a thoughtful and sensible person with a lot to contribute to the national debate, is so caught up with angry defenses of the brilliance of policy making during the Bush era that he misses our point entirely… [E]xcept for a minority of true believers, the American public largely believes that Bush failed, and no matter how many blog posts ex-Bush officials write, that isn’t going to change anytime soon. There are lots of intelligent people out there who think this is a gross injustice, and want the national conversation to focus on setting the record straight. For its own sake the Republican Party has to deafen itself to their piteous pleas; they are sirens luring the sailors to their destruction on the rocks. This will sound harsh and unfair to some, but it is true and it is real.”

“Mr. Wehner’s touching, honorable but politically toxic Bush loyalty is the kind of gift left-leaning Dems pray for night and day. Liberals want the Republican Party to spend the next four years defending the Bush record as strongly as possible. They want potential conservative presidential candidates to say as many things as possible that will tie them to Bush in the mind of the public. They want Mr. Wehner’s approach to be mandatory for the next generation of Republican candidates; they want loyalty to the Bush legacy to be a litmus test for decades to come. They want to use President Bush the way their grandfathers used Herbert Hoover, and if Mr. Wehner has his way, they will.”

A smarter approach, in my view, is understanding the primary lesson of the failure of Bush’s administration: the essential need, in all administrations, of a healthy skepticism of the power of government to do good. My conversation on that point comes up in this friendly debate I recently had with Wehner, which you can see here:

Central to the conversation this week will likely be another reconsideration of Iraq – what led Bush to undertake the war, what went wrong, and why it went wrong. Lost in the conversation will be what lessons the Democrats themselves, particularly President Obama, failed to learn from the case-making for Iraq in advancing his own signature policy. Ezra Klein responds to that comparison from me this morning, but along the way, I think he misses the point.

The Iraq war debacle shows us why it’s important to make the case for policy on the actual grounds the principals believe in, instead of an argument based on building up fear or overpromising on outcome. Rather than resting the case for war on the moral argument for human freedom neoconservatives held, Bush advanced a case designed to bring along the realists, based on faulty intelligence, about the burgeoning threat of weapons of mass destruction. Instead of basing his case for his health care law on its true justification and the moral argument for universal coverage, Obama promised it would address problems it never will, resulting in lower premiums for all, better quality care, and keeping your doctor and plan if you like them.

For both parties, the trouble was in making these policies a reality, which proved far more challenging than either expected. Iraq remains a Republican millstone – Obamacare may be about to become one for the Democrats as well. Foreign policy failures and domestic policy failures are different in significant ways, but one consequence of the latter is that everything that breaks is blamed on the most recent big reform. For the foreseeable future, everything wrong with health care is going to get blamed on Obamacare, fairly or not, and its effects on doctors, providers, and systems across the country.

If Obamacare meets its promise to lower premium costs, let you keep your doctor and your plan, trim the deficit, and improve the quality of care, Democrats will be running on it for generations. If it doesn’t, they will have to run away from it, or run by saying how they’ll fix it. Though fixing it, as we saw with the surge, doesn’t erase blame for the original mistake.

The Hillreports that [HHS] just announced that it signed an agreement to spend another $8 million—with the option to spend more—further promoting the exchanges… I’ll give the folks at HHS this: They could probably use some effective marketing. But maybe they ought to consider scaling back a bit, and work more on trying to raise awareness about the law’s benefits with Sen. Max Baucus? When you’ve already spent $3 million promoting ObamaCare’s exchanges, and yet the senator who claims to have written the bill on which the law was based thinks those exchanges are about to be a “huge train wreck,” you kind of have to wonder whether the agency is really getting much value out of its marketing budget.

But market they will have to, given the very real concerns about getting enough healthy people signed up for the exchanges. If only the sick do so (the healthy having less of an incentive), you’re going to see premiums explode at an even faster rate than previously expected. Had you built Obamacare around approaches that were actually designed to address the number one problem according to most Americans – high premium costs – instead of that moral agenda for universal coverage, you wouldn’t need to do all this spinning: people would want to buy a product because it’s priced reasonably. But you didn’t, it isn’t, so you have to lean on the marketing and hope for the best.

The feeling during the second term among many in the Bush administration was that their problem was one of public relations, not policy ramifications. They rarely questioned their policy approaches. They felt, as Wehner still feels, that things were going well far past the point where they weren’t. They blamed media reports, echo chambers, and partisan posturing for shifting public opinion. Today we see the same traits still in place in this administration: If only we promote this better, and more thoroughly, it will result in better outcomes. It’s hardly a new trend in political governance, and whoever comes next to the White House will feel it, too.

A healthier lesson to take from the Bush and Obama years is that it’s better to be honest with the American people than to approach them with false hope or false fear. They shouldn’t count on policies or approaches which accomplishes all the missions, offering everything and delivering so much less. Politicians like to promise the world, but we’d be better off, and so would they, if they were honest about the limitations of their power to deliver.